Who’s Allowed in the Public Square? And who Gets to Decide?

by The Center for Bioethics and Culture on October 13, 2011

By Jennifer Lahl, CBC President

Despite all our society’s talk of civility these days, it seems the public square is only becoming more of a lion’s den. And people of a certain stripe are being excluded or marginalized purely on the basis of their religious beliefs.

Case in point: Recently, I was invited to speak at the annual professional conference of the Canadian Fertility and Andrology Society on the topic of my film Eggsploitation, a documentary which explores the issue of egg “donation.” When the invitation was first given, I told the conference organizer that I knew the message of my film and most of my writings on Assisted Reproductive Technology in general, and egg donation in particular, would not be very welcome. In fact, I made it clear that I had no intention of coming into the lion’s den. I was assured by the conference organizer that I would be treated civilly, and that they really wanted to hear from me and engage all sides of the issue, hearing from all points of view. So I agreed to go and present.

Which brings me back to Canada. My presentation was based on the facts as we know them, and the real life stories of egg donors I have met in my decade of work in this field who have been adversely affected by selling their eggs. Egg donation carries health risks to the young women who choose to donate or sell their eggs; sometimes, in rare instances, those risks include death. Fertility drugs have risks, as does the surgical procedure a young woman undergoes in order to have her eggs harvested. The longer-term risks (e.g., risks to a donor’s own future fertility, and the risk of developing cancer) have not been studied. Egg donors are not tracked after the procedure to see what becomes of them down the road.

Informed consent is therefore meaningless. How can you inform someone of risks when you’ve never studied what you are asking them to do? And even more importantly, the woman who is often motivated by financial incentives of tens of thousands of dollars will ignore any risks that she does know about, because she is in need. So, in fact, “eggsploitation” happens to young women who are enticed by high-paying ads to “help make dreams come true.” As the film attests by telling these women’s stories, even when things go wrong, their symptoms are ignored, and they are advised to “stay the course” lest they have a failed cycle, which means they don’t get paid.

My interlocutor in Canada was a fertility specialist from the Washington, D.C., area. He described himself as a Darwinist, secularist, and Jewish. His presentation consisted of a personal attack on my Christian faith and those who I work with who share that faith. His slides showed such things as where I received my master’s degree in bioethics, who our directors are, and their Christian credentials. He focused on my writings on our website and on other Christian sites, as well as the winners of our annual Paul Ramsey Award. In the end, he told the audience that he wanted them to know who I really was and that my credentials — or, as he saw it, my bias — discounted me from speaking. He spent three quarters of his time on ad hominem attack. The Canadian Press called it a “verbal mauling” and stated that a fellow panelist and I were “eviscerated.” One woman in the audience told a journalist, “I said I was uncomfortable. I should have said I was ashamed as well.” She added: “I was just shocked. I’d be shocked to see any speaker, whether I agree or disagree, treated like that.”

Interestingly, my opponent’s closing remarks supported many of my points, notwithstanding our different worldviews. He stated that we needed to follow up with and track egg donors and establish a national registry. Why would he suggest this? He didn’t say, but I assume it is because he knows the facts: This is risky business with unknown long-term complications. He added that we should have standard informed consent. Why? So, that women are being told the truth, I suppose — that this is a procedure that is not without risk. Then my opponent added that payment should be standardized. Why? Maybe because he agrees with me that money is a coercive incentive to engage in risky behavior?

It’s too bad he didn’t open with his closing remarks, because that would have emphasized just how much we actually had in common. During my own presentation, I was asked what would be an ethical way forward. I stated that for a start, informed consent must remove all financial compensation from the decision and advise women that we have never studied the long-term effects of egg donation on young women, and we currently have no plans to do so. Therefore, we have no idea what medical and psychological risks we are asking you to assume. Would you still like to donate your eggs?

It was hard to endure such a personal attack, in front of an audience of about 200, many of whom cheered him on. And from someone who essentially agreed with me! But I know that we have a right to have our voices heard in the public square and not be muzzled. It is much more refreshing to have a truly open public square, where we can civilly air our differences, find areas of common ground, and move the ball forward. And our religious beliefs should not exclude us from public discourse, especially on matters of life and death. Let’s be sure that our worldview informs our argument so that we can continue to put forth the best ideas and in the most charitable way. Despite that bruising experience, I resolve not to be silenced and to be a voice for such a time as this.